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Affording an IBCLC
Because of the Affordable Care Act, every insurance is required to cover lactation support. On this page, you will learn what free lactation support groups exist, what IBCLCs take what insurance, & insurance information on ways you can have your insurance cover a visit with an out-of-network IBCLC.
Lactation Support groups
Lactation support groups are best for general lactation advice or if you don't know where to start in finding lactation help. Please read each groups description and check if they require registration.
Insurances Accepted by
Birth to Breast
Insurance options
When a provider is not in your insurance network you may have a few options to still have all or some of your consult covered.
Options
Superbill
This option may work for most PPO insurances and Tricare. For this option, the client pays the lactation consultant out-of-pocket and the lactation consultant then sends the superbill to their provider for reimbursement. On occasion, the health insurance may ask for a statement from the client stating why they weren't able to see anyone in-network and a letter of necessity from the baby's pediatrician.
Gap coverage
Gap coverage is an option used mostly for PPO insurance. For this option you would call your health insurance ahead of time and request to see the out-of-network provider. The Out-of-network provider must be willing to bill your insurance directly. If your insurance does not pay out you will still be responsible for the consultation cost.
Flexible spending accounts
Using a flexible spending account or health spending account is typically an option for PPO insurance and can be a great one for families with United Healthcare. For this, you would pay for your consultation with your flexible spending account card. Requesting a superbill can be handy in case your insurance wants to know more information.